Heart Ablation Procedures

Cardiac ablation is a common procedure used to correct abnormal heart rhythms. Conditions such as Wolf-Parkinson-White syndrome, atrial fibrillation, and paroxysmal tachycardias can be cured with cardiac ablation. During cardiac ablation, the surgeon effectually kills the part of the heart that is causing the abnormality.

Types of Ablation

The Maze procedure is a traditional open heart ablation procedure. The initial incision is made vertically through the chest wall. The surgeon makes more small incisions directly on the heart. This interrupts specific electrical conductions causing the arrhythmia. Scar tissue on the healed heart will continue to block the abnormal impulses. The heart may be put on a by-pass machine during the surgery. The Maze procedure is rarely used due to advancements in cardiac ablation techniques. This is the most invasive of the three heart ablation procedures, and the patient is completely anesthetized.

Surgical ablation is done with small incisions and a lighted camera called an endoscope. Decide with your doctor whether complete or light sedation is best for you. A small incision is made in the chest. The endoscope is placed in the incision, and the heart is visible on a monitor. The doctor will make small incisions on the heart where electrical impulses are causing arrhythmia. The scar tissue formed around the small incisions will block any impulses from creating abnormal beats. The heart is not stopped during surgical ablation.

Non-surgical ablation uses lasers to create scars on the heart. This is done by inserting a catheter into a blood vessel in the neck or groin. The surgeon guides the catheter through the blood vessel to the heart. The catheter is equipped with a small camera and a laser scalpel. The surgeon uses the laser scalpel to make small cuts on the heart to disrupt the electrical flow causing abnormal beats. This minimally invasive surgery is performed with precision while the patient is mildly sedated.

Mapping

During catheter and modified maze ablation, the surgeon uses the catheter to gather information about the heart. Heart beats, heart rate and electrical pathways are mapped. The surgeon triggers a faulty rhythm so the defect can be seen. The surgeon uses this information to determine which parts of the heart need to be ablated to restore proper function.

Risks

The Mayo Clinic website states that cardiac ablation is an extremely safe and common surgery. If you are anesthetized during your surgery, you have the added risk that anesthesia brings. This is why the Maze procedure is the least commonly performed ablation. Risks of ablation include bleeding from the incision and damage to the inside of your blood vessel where the catheter was inserted. Blood vessels between the heart and lungs may narrow. Blood clots may form and put you at risk for stroke. The most serious complication---heart puncture---is also the most rare. It occurs in less than 2.5 percent of all patients according to the Food and Drug Administration.

Recovery

Recovery begins as soon as the procedure is over. You will need to lay completely still for four hours to lessen the chance of forming a blood clot. During this time, your heart will be closely monitored. If your heart is beating normally six hours post surgery, you may be allowed to complete your recovery at home. Expect mild soreness for one week. Most people who have had cardiac ablation feel well enough to resume daily activity within just a few days.

Results

The cardiac ablation procedure is usually successful. Occasionally patients need to return to the hospital for repeat procedure. This is usually because the surgeon left an extra electrical conduction route open and did not completely resolve the problem during the first operation. If you experience heart rhythm problems after the procedure, let your cardiologist know.

References

• Heart Rythm Society
• University of Calofornia Medical Center
• Mayo Clinic

Resources

• FDA on Cardiac Ablation